Provider Demographics
NPI:1477977189
Name:THE EMMANUEL HOME III
Entity Type:Organization
Organization Name:THE EMMANUEL HOME III
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGEMENT
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:MEADOWS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-607-2041
Mailing Address - Street 1:5212 SWEETBRIAR DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-4544
Mailing Address - Country:US
Mailing Address - Phone:919-607-2041
Mailing Address - Fax:919-890-5571
Practice Address - Street 1:405 MORSON ST
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27601-1559
Practice Address - Country:US
Practice Address - Phone:919-607-2041
Practice Address - Fax:919-890-5571
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-17
Last Update Date:2014-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care